| Immunization admin first vaccine component CPT 90460 • Preventive Care | $18 | $19 | $21 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $9 | $10 | $11 |
| Immunization admin injection single CPT 90471 • Preventive Care | $10 | $15 | $21 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $10 | $10 | $10 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $329 | $329 | $329 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $230 | $244 | $258 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $102 | $103 | $104 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $22 | $22 | $22 |
| MMR vaccine CPT 90707 • Preventive Care | $21 | $72 | $100 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $50 | $50 | $50 |
| Varicella vaccine CPT 90716 • Preventive Care | $192 | $193 | $195 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $117 | $117 | $117 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $216 | $217 | $219 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $78 | $93 | $108 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $81 | $81 | $81 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $61 | $61 | $61 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $95 | $115 | $135 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $92 | $92 | $92 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $107 | $107 | $107 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $116 | $116 | $116 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $49 | $73 | $98 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $52 | $63 | $74 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $74 | $88 | $103 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $81 | $97 | $114 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $82 | $86 | $89 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $88 | $88 | $88 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $52 | $62 | $72 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $28 | $29 | $31 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $44 | $117 | $189 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $127 | $330 | $533 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $127 | $330 | $533 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $112 | $122 | $126 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $120 | $124 | $129 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $80 | $83 | $87 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $45 | $159 | $272 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $289 | $289 | $289 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $45 | $158 | $272 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $292 | $292 | $292 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $335 | $335 | $335 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $198 | $198 | $198 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $68 | $88 | $108 |
| Spirometry CPT 94010 • Pulmonology | $26 | $36 | $45 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $35 | $35 | $35 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $21 | $44 | $66 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $18 | $31 | $45 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $121 | $159 | $179 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $13 | $29 | $45 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $12 | $12 | $12 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $39 | $49 | $59 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $14 | $28 | $48 |